34 coding auditor jobs found

Job Type Full-time Description University Health Network is seeking a Full-Time Coding Auditor. This role requires normal business hours Monday-Friday and is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region. UHN Auditor provides superior customer experience by educating internally and externally of errors and opportunities for improvement discovered during routine auditing. This individual will work closely with management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. The UHN Auditor performs duties in a professional manner while exercising good judgment and ethical standards, interacts effectively and builds respectful working relationships across the organization, and demonstrates integrity by adhering to high standards of personal and professional conduct. This...

Position Summary The Coding Auditor conducts quality audits to ensure that medical diagnostic codes submitted to CMS (Centers for Medicare and Medicaid Services), New York State Department of Health (NYSDOH), and other entities are accurate based on the practitioners' medical record documentation of Healthfirst members' health conditions. Duties & Responsibilities Audits data, claim submissions, and member medical records for completeness, accuracy, and compliance with Healthfirst policy and documents findings per departmental procedure Identifies patterns of under-performance, noncompliance, and inconsistencies and recommends resolutions Evaluates the quality of medical coding and notifies management of discrepancies, as needed. Conducts internal audits of medical record reviews performed by colleagues Collaborates with other departments to improve compliance with coding conventions and clinical practice guidelines Supports continuous improvement and quality initiatives...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

Location :RemoteSalary :$85,000depending on experienceSkills :Auditing, Inpatient Coding, DRG Validation, Quality ReviewAbout the Company / Opportunity :Are you passionate about upholding quality standards in health information management and coding practices? Our client, an industry leader in the hospitals and health care sector, provides nationwide revenue cycle services to a vast network of hospitals and physician practices.This remote opportunity allows you to leverage your expertise in coding quality review, ensuring compliance with national guidelines and maintaining data integrity.Join a mission-driven organization focused on supporting patient outcomes and enhancing health care delivery through excellence in coding quality.Responsibilities :Lead, coordinate, and perform all functions of quality review for inpatient and outpatient coding across multiple facilities.Conduct routine, pre-bill, policy-driven, and incentive plan-driven coding quality audits to ensure compliance...

Hospital Auditor The Hospital Auditor is responsible for reviewing hospital (inpatient and outpatient) to ensure accuracy, completeness, and compliance with regulatory guidelines and coding standards. This role supports the team's broader mission by identifying documentation gaps, validating coding accuracy, and assessing the effectiveness of hospital practices. Through targeted feedback and education, the Hospital Auditor helps strengthen documentation quality, promote compliant billing, and safeguard reimbursement integrity, ultimately contributing to improved patient care and organizational compliance. Responsibilities Conducts comprehensive record reviews to identify documentation gaps and best-practice process improvement opportunities. Performs high-level secondary case reviews to ensure accurate, complete, and compliant provider documentation. Assesses documentation alignment with ICD-10-CM/PCS, MS-DRG/APR-DRG, and payer guidelines, identifying missed or...

Overview Ardent Health is a leading provider of healthcare in growing mid-sized urban communities across the U.S. With a focus on people and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. Through its subsidiaries, Ardent delivers care through a system of 30 acute care hospitals, 24,000+ team members and more than 280 sites of care with over 1,800 affiliated providers across six states. Position Summary The Hospital Auditor is responsible for reviewing hospital (inpatient and outpatient) to ensure accuracy, completeness, and compliance with regulatory guidelines and coding standards. This role supports the team’s broader mission by identifying documentation gaps, validating coding accuracy, and assessing the effectiveness of hospital practices. Through targeted feedback and education, the Hospital Auditor helps strengthen documentation quality, promote compliant billing, and safeguard reimbursement...

Ardent Health seeks a Hospital Auditor to review inpatient and outpatient records for accuracy, completeness, and regulatory compliance. The role identifies documentation gaps, validates coding accuracy, and strengthens billing integrity to support reimbursement and patient care quality. The candidate should have 3+ years MS DRG/APR DRG experience, Epic proficiency, and coding certifications (RHIA, RHIT, CCS, CIC, CCDS, CDIP or CPC). Strong communication and analytical skills are essential. #J-18808-Ljbffr

Ardent Health is seeking a Hospital Auditor to review inpatient and outpatient records for accuracy, completeness, and regulatory compliance. The role involves identifying documentation gaps, validating coding accuracy, and assessing hospital practices to strengthen documentation quality and safeguard reimbursement integrity. The position requires strong MS DRG/APR DRG experience, ICD-10-CM/PCS expertise, and the ability to communicate findings effectively to providers and leadership. #J-18808-Ljbffr

Ardent Health Services is seeking a Hospital Auditor to review inpatient and outpatient records for accuracy and regulatory compliance. You’ll identify documentation gaps, validate coding accuracy, and support education to strengthen reimbursement integrity and patient care quality. Responsibilities include conducting comprehensive audits, analyzing findings, and delivering detailed reports to stakeholders, with strong emphasis on CMS guidelines and coding standards. #J-18808-Ljbffr

Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to medical coding and...

Experienced Associate, Healthcare ForensicsThe Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients.Job Duties:Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance mattersContributes to forensic engagements related to medical coding and...

## Compliance AuditorApplylocations: MHC Nashville, TNtime type: Full timeposted on: Posted Todayjob requisition id: JR102201Ranked one of Tennessee’s top places to work, MHC is a rare and special place where outstanding company culture is intentional. Where clients and associates are treated the same, as equals.Mental Health Cooperative, Inc. (MHC) was formed in 1993 to serve individuals with severe and persistent mental illness. Since then, we have expanded our services to children and adolescents with severe emotional disorders across Middle and East Tennessee.Our sole purpose is to support and treat those challenged with serious mental illness and poverty. Although based out of Nashville, we serve several communities across middle and East Tennessee with satellite offices in Antioch, Gallatin, Dickson, Columbia, Cleveland, Murfreesboro, Clarksville, Cookeville, Chattanooga, and Memphis.If you are interested in joining a team that is caring, collaborative, innovative...

Quorum Health Corporation in Brentwood, TN, is seeking a Senior Coder to lead inpatient and outpatient coding operations remotely. You will oversee coding quality, guidelines adherence, and staff education while collaborating with CDI and audit teams. The role emphasizes accurate, compliant coding, denial management support, and process improvements across Revenue Cycle, with focus on AHIMA standards and federal/state rules. #J-18808-Ljbffr

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology's mission and vision. Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve. Job Description: Role Summary The Medical Billing Specialist works under the direct supervision of the Director, Billing and AR. Responsibilities include all aspects of charge capture for Medical Oncology which entails accurate...

Possess a thorough working knowledge of the revenue cycle management process including; ICD-9, ICD-10, CPT-4, and HCPS Billing.Responsibilities include ensuring that reimbursement is maximized through accurate and appropriate coding.Accountable for staying abreast of government policies and procedures as it relates to coding to ensure that company conforms to applicable guidelines and regulations.Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion and safety.MinimumHigh School Diploma or GEDCertified Medical CoderStrong understanding of industry / technical terms and processesExceptional customer service skillsStrong analytical and problem-solving skillsStrong attention to detailExcellent oral / written communication skillsDesiredBachelor's Degree2years medical coding experience- Abstract clinical information from medical records to document, assign, and sequence ICD-9 and / or CPT-4 and HCPS coding where appropriateAudit, review, and correct...

Coder AnalystAnalyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives. Abstracts and enters data from the medical records in order to maintain a database for statistics and reporting. Assists the Billing Department in timely billing and rebilling of patient information.ResponsibilitiesReviews documentation in the medical record to determine ICD-10 CM and CPT-4 coding that is needed to comply with billing and reimbursement guidelines set forth by government entities.Verifies data in the medical record and accurately abstracts pertinent information for charge entry.Appropriately utilizes CPT-4 and ICD-10 current procedural coding standards in assisting the provider with proper selection and assignment of the principal procedure(s) and related diagnosis.Edits unbilled...

Tennessee Orthopaedic Alliance, the largest orthopaedic surgery group in Tennessee, seeks a Certified Coder to ensure accurate coding and documentation for professional services. This role emphasizes CPT-4, ICD-10, HCPCS knowledge and collaboration with providers for audits. The position may involve work-at-home options within the Middle Tennessee region; candidates should reside near Knoxville or Columbia areas for on-site requirements. #J-18808-Ljbffr

Tennessee Orthopaedic Alliance (TOA) is the largest orthopaedic surgery group in Tennessee. We are seeking a Certified Coder to ensure accurate coding of charges and compliance with CPT-4, ICD-10, HCPCS in a busy practice. Responsibilities include reviewing records, abstracting diagnoses and procedures, and educating providers on audit results while maintaining professionalism. Must reside in Middle TN, Columbia, or Knoxville area and hold CPC or CCS-P certification. #J-18808-Ljbffr

Coder Analyst Specialist Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group Overview: Covenant Medical Group is the employed and managed medical practice organization of Covenant Health, providing comprehensive care across East Tennessee. With more than 300 physicians and advanced practice providers in 20 communities, our team delivers expertise across a broad spectrum of specialties from primary care and walk-in clinics to preventive medicine and advanced surgical and subspecialty services. We are committed to offering coordinated, patient-centered care that spans the continuum of health needs, ensuring access to exceptional providers close to home. Position Summary: Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives. Abstracts and...

Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! Impact - TOA's team members use our careers — whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life. Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. Total Rewards - TOA offers a comprehensive suite of benefits, including...

Physician Coder III, RemoteErlanger Health hires employees for telecommuting/remote positions in the following states: AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, PA, SC, TN, TX, VA, WI, WYJob Summary: The Physician Coder III is responsible for coding of physician and/or mid-level provider professional services. Recognizes and completes a high-volume workload accurately and in a timely manner, with minimal direct supervision. Follows set procedures to achieve goals. Displays professional office skills and ability to navigate a practice management system. Functions as liaison between management, the physician practices and employees working within physician practices. Coder will provide CPT, HCPCS and ICD-10-CM coding a minimum of 1-4 specialties. Specialties could include UR, Podiatry, Plastics, Pediatrics, OB, Pain Management, Ortho, Addiction, General Surgery, Internal Medicine, Urgent Care, Pulmonary, or ED. Facility Chart types could include OT, PT, Urgent Care, ED,...

Quorum Health is seeking a Senior Outpatient Coder to lead inpatient and outpatient coding workflows with a focus on accuracy and compliance. The role supports denials reviews, audits, and staff education while aligning with organizational goals for revenue integrity. You will collaborate with Coding Leadership and CDI teams, applying official guidelines and payer requirements to ensure timely, compliant coding across hospital-based services in a fully remote capacity. #J-18808-Ljbffr

Tennessee Orthopaedic Alliance, the largest orthopaedic surgery group in Tennessee, seeks a Certified Coder to support accurate coding for professional services and surgical procedures. You will review records, ensure proper diagnoses and CPT/HCPCS codes, and educate providers on audit results. Applicants must have 1 year of surgical coding experience and CPC or CCS-P certification, with strong medical terminology knowledge. #J-18808-Ljbffr